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diagnosis differential algorithm nephrology criticalcare management treatment alkalosis beriberi chloride classification comparison deficiency effects elevation foamed heat heatstroke hyponatremia illness
Lactated Ringers (LR) vs Normal Saline (NS) - Comparison Composition of LR: • Sodium 130 mEq/L •
/L of sodium lactate ... NOT lactic acid ... shift • Saline Causes ... decreased renal blood flow ... • Saline May Cause
Lactic Acidosis - Differential Diagnosis Framework Type A: Impaired O2 Delivery (DO2) • Decreased O2 Delivery: Hypotension
Lactic Acidosis ... Ischemia, Compartment Syndrome ... Hypothermia & Shivering, Seizures ... Beta-Agonists, ↑ work ... toxic alcohols, Sodium
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... • Euvolemic (Low ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Algorithm #nephrology #sodium
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis The most common causes of hyperlactatemia are usually:
Causes of Lactate ... Causes of Lactate ... LV failure - Low ... - Compartment syndrome ... #Lactic #Acidosis
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
alkalosis • Normal/low ... , Gitelman syndrome ... ketoacidosis • D-lactic ... the indicated causes ... the excretion of sodium
Thiamine Deficiency - Differential Diagnosis Framework and Clinical Manifestations Causes of Thiamine Deficiency: • Poor intake: - Diets
Manifestations Causes ... rice, Cereals • Low ... also seen • Lactic ... acidosis may not ... - Increased Lactate
Hyponatremia - Diagnosis and Treatment Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... the underlying cause ... demyelination syndrome ... of symptomatic (seizures ... management #nephrology #sodium
Heat Illnesses and Heat Stroke - Differential Diagnosis Framework Heat Cramps: • Muscle pain or spasm -
Dehydration - Loss of sodium ... conditions - Neurogenic ... heat illness → Hypernatremia ... consciousness, Coma/seizure ... Possible DIC - Mild lactic
There are similarities and differences between these 3 conditions which all carry treatment implications. Each mimic
hormones that work ... But we also have Lactic ... convert Pyruvate to Lactate ... for Refeeding Syndrome ... both conditions, low
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